HomeMy WebLinkAboutBLD2024-00203 - BLD CD Environmental Health Review - 2/20/2024 MASON COUNTY PermitNo: BLm22j-oWo3
COMMUNITY DEVELOPMENT RECEIVED
PermHA88istance Center,Building,Planning FEB 15 2024
BUILDING PERMIT APPLICATION
615 W. Add
PROPERTY OWNER INFORMATION: CONTRACTORINFORMATION: TSVBRt
MAMENFALIOY,O IJCRIN NAM&COUMYLINEIIEVELOPMENT m
MAESNGADDRESS:U18CANTERRURYLII MAIJNGADDEESS:1811PADMCKRO
CTTY:�M STATE:WA ZINMMOa CTIY:CEMRALLA STAMINA ylp;p t T z
PHONE#1:x8pam0M PHONE: CELL:
PHONE#2: �= O
EMAIL: L&I L&l RE RE G#couNrtn28va EXp, 5
PRIMARY CONTACT: OWNER CONTRACTOR El OTHER❑ T Z
NAME Mwa y EMAIL In a I NT,11 OEVELCPAEMuc.cON K
MAILINGADDRESS 1811 PA➢RICKM CITY®neMM STATE WA R`P M v
PHONE CELL r®N m
PARCEL INFORMATION: Z�
PARCELNUMBER(12 DLit Np )L2206a1L1086 ZOIOTTO Q,� D
y PGALDESCR@TION(Abbrtyiatcd)tARE cuaXNAx91eat1Ctl11T:as FIRE DISTRICT (—
STIE ADDRESSWN WGEM RACE SOUTH LTTYHOODBPORT
DIRECTIONS TO SITE ADDRESS
101 TOWARDS( CUSHMAN,LEFT CN WIGEON PIACE c�
MS PROJECTWLTR¢i3N0 OFBLOPE(3)GREATERTHANIB%: YES[] NO� SNOWLOAD:yLW
ISPROPERTYWTT 200FTOFTREFOLLO G: Tche�t.uuwygyJ:
SALTWATER❑ LAKE❑ RIVER/CREEK❑ POND❑ WETLAND[] SEASONALRUNOFF❑ STREAM[]
TYPE OF WORK: NEW Ca ADDITION❑ ALTERATION[] REPAIR[3 OTHER fl
USE OF STRUCTIM(Ru ar,gAC aws,e )MSIOENCE
ISUSE: PRDTARYO SEASONAL[] NUMBEROFBEDROOMS1 ;L NUMBEROFBATBROOMS2
HEATED STRUCTURE? YES Ne .. []+ YES(Pmfl)elID ❑ NO
DESCRIBE WORRNLW MNIUFACNRED HOME FtACENEM
SOUARE FOOTAGE:rpm
1STFLOOR1812 p,R 2NDFLOOR ap.R. 3RDFLOOR_p.ft BASEMENT p.ft.
DECKQ p.fL COVEREDDECKHO p.R STORAGE p.R OTHER N.H.
GARAGE_p,It kwhed[] De2pcheA❑ CARPORT p.k Al [] Dd. []
MANUFACTURED HOME INFORMATION: e4 COPIES OF THE FLOORPLAN REQUIRED•
MAEECMFGMENWEST MODELDRMM2F YEAR2m4 IE,=w
WIUTH2T BEDROOMSY L BATE52 SERIAL NUMBERTED
ENVIRONMENTAL HEALTH:
SEWAGEISEWER SOURCE: SEPTIC SEWER❑ / NEW[] EXISTINGE
PLumUNGINSTRUCTURET YESD NO[] #J.,anaeh eo.Pfaad Wm Adpepey F..
PER]METEWFOUNDATION DRAINS PROPOSED] YES❑ NOE ERI517NGSQFT.
EXISTINGBEDROOMS D PROPOSEDBEDROOMS a' TOTALBEOROOMS 7-
OIVNEReWwwhtl MrtwbmiaeianWin..In1b-.n mry ti51n by
NgreNre bebx.l tletleretYa[I em tM1e psnareM I tuMar Eetlere NN I un eMMO tp nuMtlilO pvmX eM to Eo Me woM1 es proppsM.l M1aw
obtainNpeemAssionfmm ell Ne necesserypeNea,IMUI enyeaeanem M1OIEer or peNlse dlnlerettngmdrp , In.. dowiw lapel
represenletire,represeNs Net Neinlo—m js mnnw p ne m anEnesn B1-.1IIs of Masonh—w eves to n sb ninon CpfflnI
aM aor,Nr (¢)!a reNew anE incpeclion. ra pmmMappbmtim bxdnea null6 voiE iluwko-eulM1onz�wnzbu lion is nW wmmenced xMln1W
6fyanR BVu wA168o8p0 eE lOra pMp]d1SO Ceye.
PROD OF ONTI UATI OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS
PE IT PLI TION 0 DAYS OF M E WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON
COUNTY CODE 14.06.42)
X OL�Irl�jJ
IOnaWre 0OM61 BFta<M aI by Ma OWNER( DaN
DEPARTMENTAL REV APPROVED I DATE DENIED : DATE TAGGNOTESPOHNDTTIONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT
FIRE MARSHAL
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EH APPROVED
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